The Effect of Intra-myometrial Methylergonovine Injection Versus Placebo on Decreasing Blood Loss During Trans-abdominal Myomectomy: A Randomized Controlled Interventional Clinical Trial

Abstract

Uterine leimyomas are tumors of the smooth muscles and the connective tissues of the uterus. They are considered to be the most common benign pelvic tumor affecting about 20% of women above the age of 35. The diverse symptomatology of fibroids can be attributed to size, number and location of the tumors. The common symptoms include menorrhagia, infertility, abdominal mass and pressure effects. Most fibroids do not require treatment unless they are causing symptoms. In patients who have symptoms the treatment of uterine fibroids may be medical or surgical. Surgical management consists of total or subtotal hysterectomy and myomectomy, but in some cases less invasive procedures, such as uterine artery embolization may be successful. Myomectomy is a common surgical treatment option for patients with symptomatic fibroids who wish to preserve their fertility. Myomectomy is the removal of the fibroid(s), while leaving the uterus in place. The most serious complication during abdominal myomectomy is severe intra-operative hemorrhage. Uncontrolled hemorrhage may necessitate hysterectomy. Thus several methods are employed to decrease blood loss during the myomectomy operation.